"Dangerous" Drug interactions

[wantpeace]

So I was prescribed a new drug yesterday to take the edge off the restlessness I'm getting from starting up Escitalapram.

I went to look it up to make sure I knew when to take it, e,g, with or without food.

Turns out a certain website: drugs dot com to be precise, says there are potentially fatal consequences to the combination of drugs I'm on - although it points out this is rare, whatever that means.

Now I'm concerned. Should I be taking the combination I'm on. I've written to my psychiatrist with my concerns.

Is it quite common for "theoretically" fatal drug combinations to be prescribed?

My combo causing concern is Atarax, Escitalapram and Quetiapine.

[MyNameIsTerry]

Drugs.com is a reliable source.

It's the long QT syndrome issue with this interaction. The Major interaction is between the Escitalopram and Quetiapine. However it is rare and if you clicked on the Professional tab of the interaction checker you would have seen that the recommendation is to monitor the patient and educate them on what to look out for. It also mentions there is an increased risk to people with certain heart conditions including the long QT syndrome and this is why psychiatrists may look to see if the patient has had a test that shows this is not present or may do one of their own.

If it was a GP I would be concerned as they often don't understand these meds, let alone the interactions, but a psychiatrist would.

To add some perspective to the "rare" issue and the Major interaction status, consider that:

- when doctors switch us between various meds many combinations have Major interaction for Serotonin Syndrome, which can also be fatal although it can also be mild too. This is a necessary process and so doctors are expected to monitor the patient.

- there are people on here with a combination of meds that also show as Major interactions for Serotonin Syndrome but their psychiatrists have actually put them on these combinations as they can combine to work better for some patients. These patients will be monitor and probably had initial tests on their hearts to rule out things like long QT syndrome too.

So, yes it is rare but it's not rare for these interactions to be overruled by psychiatrists where they deem the benefit to outweigh the risk.

If you look at the side effects against Escitalopram on Drugs.com as an example, you can see the Rare category (which includes Serotonin Syndrome) is <0.1%. That's extremely low. So, when you think about those extreme side effects listed on there, they could also put people off too but I think you know how unlikely those to be as I've seen you giving good advice to people on here about not reading into things like that.

I'm sure if you asked your psychiatrist about this he/she would reassure you.

[wantpeace]

I'm sure if you asked your psychiatrist about this he/she would reassure you.

Thx for your detailed response Terry. I did ask my psychiatrist. She said I've had ECG's before and they've been fine. However, because I've only just gone on to Escitalapram again and Atarax has been added, she has written to my GP about having another one.